COURT APPOINTED ATTORNEY APPLICATION AND PREFERENCE FORM

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1 COURT APPOINTED ATTORNEY APPLICATION AND PREFERENCE FORM Please provide the following information as a part of the application and verification process for Court-Appointed Attorneys. This application must be completed in its entirety if you wish to be considered for appointment as a Court-Appointed Attorney in the First FORWARD COMPLETED APPLICATION TO: Chief Judge Terry Terrell Office of the Chief Judge Attention: Keri Igney M.C. Blanchard Building 190 Governmental Center Pensacola, Florida APPLICANT INFORMATION NAME: Florida Bar No. Business Address: Business Phone: Business Fax: ADDRESS: (This address is required by the Justice Administrative Commission.) Please check all of the following mandatory qualifications that apply. I am a member in good standing with the Florida Bar. I have familiarized myself with the Administrative Order(s) relating to Court Appointed Attorneys in the First Judicial Circuit located on the web site, I am familiar with and experienced in the utilization of expert witnesses and evidence, including but not limited to psychiatric and forensic evidence. I have reviewed and understand the agreement for attorneys services documents located on the JAC website at and agree to comply with JAC s requirements for billing. I have reviewed and understand the fee structure for Court Appointed Attorneys as set forth in , Florida Statutes.

2 I will not solicit compensation from the defendant or other clients on cases for which I serve as Court-Appointed attorney. I will notify the Chief Judge of any formal complaint filed by The Florida Bar against me; any non-confidential consent agreements entered into between myself and The Florida Bar; and, any claim of ineffective assistance of counsel that has been set for a hearing before a judge or magistrate.

3 ATTORNEY PREFERENCE FORM Check all Counties in which you are willing to serve as Court-Appointed Counsel. ESCAMBIA OKALOOSA SANTA ROSA WALTON Check all case types for which you are seeking appointment. Capital Cases where Death is a penalty possibility. 1 st Chair Qualified 2 nd Chair Qualified Capital Felonies Non-Capital Felonies Misdemeanor Criminal (including Traffic) Juvenile Delinquency Dependency Standard Guardianship Emergency Guardianship Parental Notification of Abortion Act Post Conviction Violation of Probation Adult Protective Services Baker Act Proceedings Jimmy Ryce Act APPEALS Capital Death Penalty Appeals Other Capital Case Appeals Circuit Criminal Appeals County to Circuit Appeals Juvenile Delinquency Appeals Dependency Appeals Guardianship Appeals Jimmy Ryce Act Appeals

4 COMMENTS: Please verify and check the following that apply. Fill in only the verification information for the case types for which you are applying. Checking a box is your certification that you meet that specific requirement for the particular court-appointed counsel standard. In cases involving the death penalty, all requirements are mandatory. DEATH PENALTY/CAPITAL CASES - FIRST CHAIR I have been a member in good standing with The Florida Bar for the previous five (5) I am an experienced and active trial practitioner with at least five (5) years of litigation experience in the field of criminal law. I have served as lead counsel in no fewer than nine (9) state or federal jury trials of serious and complex cases which were tried to completion, as well as prior experience as lead defense counsel or co-counsel in at least two (2) state or federal cases tried to completion in which the death penalty was sought. I have served as lead counsel and tried to completion at least three (3) jury trials in which the charge was murder; or alternatively, I have tried to completion at least one (1) murder trial and an additional five felony jury trials. I am familiar with the practice and procedure of the criminal courts of the First Judicial Circuit. I have demonstrated the necessary proficiency and commitment that exemplify the quality of representation appropriate to capital cases, including but not limited to the investigation and presentation of evidence in mitigation of the death penalty. I have attended within the last two (2) years a continuing legal education program of at least twelve (12) hours duration devoted specifically to the defense of capital cases. If, within the last twelve (12) months, I have not attended a continuing legal education program of at least twelve (12) hours duration devoted specifically to the defense of capital cases, I have obtained the case law update materials from the Public Defender s Office and I have reviewed said materials. DEATH PENALTY/CAPITAL CASES - SECOND CHAIR I have been a member in good standing with The Florida Bar for the previous five (5) I am an experienced and active trial practitioner with at least five (5) years of litigation experience in the field of criminal law. I have served as lead counsel or co-counsel in no fewer than three (3) years state or federal jury trials of serious and complex cases which were tried to completion. I have tried to completion at least two (2) trials in which the charge was murder; or alternatively, I have tried to completion at least one (1) murder trial and an additional felony jury trial. I am familiar with the practice and procedure of the criminal courts of the First Judicial Circuit. I have demonstrated the necessary proficiency and commitment that exemplify the

5 quality of representation appropriate to capital cases. I have attended within the last two (2) years a continuing legal education program of at least twelve (12) hours duration devoted specifically to the defense of capital cases. If, within the last twelve (12) months, I have not attended a continuing legal education program of at least twelve (12) hours duration devoted specifically to the defense of capital cases, I have obtained the case law update materials from the Public Defender s Office and I have reviewed said materials. CAPITAL SEXUAL BATTERY AND OTHER FIRST DEGREE MURDER CASES NON-CAPITAL FELONY AND MISDEMEANOR TRIALS I have been a member in good standing with The Florida Bar for the previous three (3) I have completed within the last twelve (12) months a minimum of ten (1) hours of CLE approved by The Florida Bar and devoted to criminal law. I am an experienced and active trial practitioner and have tried felony and misdemeanor and federal jury trials. I am familiar with the practice and procedure of the criminal courts of the First Judicial Circuit. JUVENILE DELINQUENCY TRIALS I have been a member in good standing of The Florida Bar for at least one year. I am familiar with the practice and procedure of delinquency proceedings in the First I am an experienced trial practitioner with no fewer than three delinquency dispositions or three state or federal trials completed to disposition. I have completed within the last twelve months a minimum of ten hours of CLE approved by The Florida Bar and devoted to criminal law. I have completed within the last twelve (12) months a minimum of at least three (3) hours of CLE approved by The Florida Bar devoted to delinquency law. ( This CLE may be part of the ten hours criminal law CLE required above.) DEPENDENCY/TERMINATION OF PARENTAL RIGHTS I have been a member in good standing with The Florida Bar for the previous three (3) I am familiar with the practice and procedure of dependency proceedings in Unified Family Court for the First Judicial Circuit including the application of the Juvenile Rules of Procedure and the Family Law Rules of Procedure. I have observed at least thirty (30) hours of hearings, including six (6) shelter hearings, three (3) dependency hearings, and one (1) termination of parental rights hearing. I have completed within the last twelve (12) months a minimum of three (3) hours of CLE approved by The Florida Bar devoted to dependency law. I have experience in handling dependency hearings and TPR hearings.

6 ATTORNEY FOR CHILD I have been a member in good standing with The Florida Bar for the previous three (3) I am familiar with the practice and procedure of dependency proceedings in Unified Family Court for the First Judicial Circuit including the application of the Juvenile Rules of Procedure and the Family Law Rules of Procedure. I have observed at least thirty (30) hours of hearings, including six (6) shelter hearings, three (3) dependency hearings, and one (1) termination of parental rights hearing. I have completed within the last twelve (12) months a minimum of three (3) hours of CLE approved by The Florida Bar devoted to dependency law. I have completed the three-hour training course fo attorneys for children offered by the Guardian Ad Litem Program. STANDARD GUARDIANSHIP I have been a member in good standing with The Florida Bar for the previous three (3) I am familiar with the practice and procedure of guardianship proceedings in the First I am an experienced trial practitioner who has represented clients in no fewer than fifteen (15) guardianship proceedings. I have completed within the last twelve (12) months a minimum of three (3) hours of CLE approved by The Florida Bar devoted to guardianship law. EMERGENCY GUARDIANSHIP INCLUDING BAKER ACT I have been a member in good standing with The Florida Bar for the previous three (3) I am familiar with the practice and procedure of guardianship proceedings in the First I am an experienced trial practitioner who has represented clients in no fewer than fifteen (15) guardianship proceedings. I have completed within the last twelve (12) months a minimum of three (3) hours of CLE approved by The Florida Bar devoted to guardianship law. I certify that I am familiar with statutory and case law for the following proceedings and certify competency to provide representation in the following proceedings: Chapter 415 for Adult Protective Services; the Marchman Act; the Baker Act; Chapter 392 for victims of tuberculosis; Chapter 744 & Chapter 765; Florida Rules of Probate Procedure Health Care Advance Directives; and Chapter 384 for victims of sexually transmitted diseases. JIMMY RYCE TRIALS I have been a member in good standing with The Florida Bar for the previous three (3)

7 I have completed within the last twelve months a minimum of ten hours of CLE approved by The Florida Bar and devoted to criminal law. I am an experienced and active trial practitioner and have tried felony and misdemeanor and federal jury trials. I am familiar with the practice and procedure of the criminal and civil courts in the First DEATH PENALTY/CAPITAL CASE APPEALS I have been a member in good standing with The Florida Bar for the previous five (5) I am an experienced and active trial practitioner with at least five (5) years of litigation experience in the field of criminal law. I have prior experience in the appeal of at least one case where a sentence of death was imposed, as well as prior experience as lead counsel in the appeal of no fewer than three (3) felony convictions in federal or state court, at least one (1) of which was an appeal of a murder conviction; or alternatively, have prior experience as lead counsel in the appeal of no fewer than six (6) felony convictions in federal or state court, at least two (2) of which were appeals of a murder conviction. I am familiar with the practice and procedure of the appellate courts of the State of Florida. I have demonstrated the necessary proficiency and commitment that exemplify the quality of representation appropriate to capital cases. I have attended within the last two (2) years a continuing legal education program of at least twelve (12) hours duration devoted specifically to the defense of capital cases. If, within the last twelve (12) months, I have not attended a continuing legal education program of at least twelve (12) hours duration devoted specifically to the defense of capital cases, I have obtained the case law update materials from the Public Defender s office and I have reviewed said materials. CRIMINAL, JUVENILE DELINQUENCY AND JIMMY RYCE APPEALS I have been a member in good standing with The Florida Bar for the previous three (3) I have completed within the last twelve (12) months a minimum of ten (10) hours of CLE approved by The Florida Bar and devoted to appellate law. I am an experienced and active practitioner in the field of appellate criminal law or have experience in the appeal of at least five criminal cases. I am familiar with the practice and procedure of the criminal courts in the First Judicial Circuit. DEPENDENCY APPEALS

8 I have been a member in good standing with The Florida Bar for the previous three (3) I am familiar with the practice and procedure of dependency proceedings in Unified Family Court for the First I am an experienced appellate trial practitioner with at least three years of experience in dependency or appellate law. I am an experienced and active practitioner in the field of appellate law or have experience in the appeal of at least five cases not limited to dependency or termination of parental rights. I have completed within the last twelve (12) months a minimum of three (3) hours of CLE approved by The Florida Bar devoted to dependency law. GUARDIANSHIP APPEALS I have been a member in good standing with The Florida Bar for the previous three (3) I am familiar with the practice and procedure of guardianship proceedings in the First I am an experienced appellate practitioner who has represented clients in no fewer than five (5) appeals. I have completed within the last twelve (12) months a minimum of three (3) hours of CLE approved by The Florida Bar devoted to guardianship law. Please provide any additional information such as experience, certifications, etc. that you deem appropriate for consideration by the Chief Judge. PLEASE NOTE: The Attorney Registry List for the First Judicial Circuit is maintained by the Office of the Chief Judge. IF AT ANYTIME DURING YOUR SERVICE AS CONFLICT COUNSEL YOU DESIRE CHANGES BE MADE TO YOUR AREA OF PRACTICE, YOUR ADDRESS, YOUR ADDRESS, YOUR PHONE NUMBER OR ANY OTHER PERTINENT

9 INFORMATION, YOU MUST SUBMIT NOTICE OF YOUR CHANGES IN WRITING TO: Keri Igney, Administrative Office of the Chief Judge, M.C. Blanchard Judicial Building, 190 Governmental Center, Pensacola, Florida with a copy to the Justice Administrative Commission. Dated: SIGNATURE OF APPLICANT

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